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EDITOR—The papers by Chiba et al and McColl et al show that in the medium term a test and treat approach in dyspepsia can be as effective or better than endoscopically led management. 12 However, an individualised approach remains prudent in primary care.

In the long version of the paper by Chiba et al on bmj.com (bmj.com/cgi/content/full/324/7344/1012), 33% of people with a positive result to the initial near patient test were negative on breath testing. Such results are important in …